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DIVISION OF RECLAMATION, MINING AND SAFETY <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, Colorado 80203 <br />Phone: (303) 866.3567 <br />FAX: (303) 832.8106 <br />P M- <br />f• 1 <br />CONSTRUCTION MATERIALS <br />REGULAR (112) OPERATION <br />RECLAMATION PERMIT APPLICATION FORM <br />CHECK ONE: ❑ There is a File Number Already Assigned to this Operation <br />STATE OF COLORADO <br />Hams D. Sherman <br />(Please reference the file number currently assigned to this operatio*)ecemre Director <br />Amendment Application (Rule 1.10) <br />New Application (Rule 1.4.5) <br />Conversion Application (Rule 1.11) <br />Permit N M (provide for Amendments and Conversions of existing permits) <br />The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (I) the application <br />form; (2) Exhibits A -S, Addendum 1, any sections of Exhibit 6.5 ( Geotechnical Stability Exhibit; and (3) the application fee. When you <br />submit your application, be sure to include one (1) comuiete signed and notarized ORIGLNAL and one (1) copy of the completed <br />application form two (2) copies of Exhibits A -S, Addendum 1. appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for <br />the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3 -ring binder; maps should be folded to <br />8 1 /2" X 11" or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. <br />2. Operation name (pit. mine or site namel: <br />3. Permitted acreage (new or existing site): <br />3.1 Change in acreage (1) <br />3.2 Total acreage in Permit arca <br />4. Fees: <br />4.1 <br />4.2 <br />4.4 <br />4.5 <br />GENERAL OPERATION INFORMATION <br />Type or print clearly, in the space provided, ALL information requested below. <br />Applicant/operator or company name (name to be used on permit): STONEWALL SPRINGS QUARRY, LLC <br />1.1 Type of organization (corporation. partnership, etc.): LIMITED LIABILITY COMPANY <br />New Application <br />New Quarry Application <br />Amendment Fee <br />Conversion to 112 operation (set by statute) <br />5. Primary commoditie(s) to be mined; SAND <br />5.1 Incidental commoditie(s) to be mined: 1. <br />3. / Ibs/Tons/yr 4. <br />Stonewall Springs <br />RECEIVED <br />OCT 29 2012 <br />DIVISION OF RECLAMARON <br />MININGAND SAFEV <br />GRAVEL FILL <br />Ihs/Tons/yr <br />I bill' onslyr <br />2. <br />1030 <br />1030 <br />52,696.00 <br />53,342.00 <br />52.229.00 <br />$2,696.00 <br />COLORADO <br />D I V I S t O H O F <br />RECLAMATION <br />MINING <br />SAFETY <br />am caner, h. <br />Governor <br />Ronald W. Gwny <br />Division Director <br />Natural Resource Trustee <br />Quarry Gravel Pit <br />permitted acres <br />acres <br />acres <br />application fee <br />quarry application <br />amendment fee <br />conversion fee <br />1 lbs/Tons/yr <br />5. / IbstTons/yr <br />5.2 Anticipated end use of primary commoditie(s) to be mined: <br />CONSTRUCTION MAT I HIALS caNORne. ASPHALT STRUCTURAL FILL <br />5.3 Anticipated end use of incidental commoditie(s) to be mined: NO INCIDENTAL COMMOITIES TO BE MINED <br />Office of Office of <br />Mined land Reclamation Deaver • Grand /unction • Durango <br />Active and Inactive Mines <br />